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A new immunochemistry based MPT64 antigen detection test has shown improved sensitivity compared to current laboratory tests. The aim of this study was to implement and validate the test performance in a resource limited African setting. Presumptive pediatric (0\u201318 y) EPTB patients were prospectively enrolled at Mbeya Zonal Referral Hospital, and followed to the end of treatment or until a final diagnosis was reached. Specimens from suspected sites of infection were subject to routine diagnostics, GeneXpert MTB\/RIF assay and the MPT64 test. The performance of the tests was assessed using mycobacterial culture as well as a composite reference standard. 30 patients were categorized as TB cases, 31 as non-TB cases and 2 were uncategorized. In the TB group, the three most common infections were adenitis (30%), peritonitis (30%) and meningitis (20%). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MPT64 test was 92%, 88%, 87%, 92% and 90%, respectively. Mortality was equally high among TB\/non-TB cases (23% vs 21%), and malnutrition was the main comorbidity among TB cases. The MPT64 test was implementable in the routine diagnostics in a low-resource setting and improved the diagnosis of pediatric EPTB.<\/jats:p>","DOI":"10.1038\/s41598-021-97010-2","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T14:32:14Z","timestamp":1632407534000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["MPT64 antigen detection test improves diagnosis of pediatric extrapulmonary tuberculosis in Mbeya, Tanzania"],"prefix":"10.1038","volume":"11","author":[{"given":"Erlend","family":"Gr\u00f8nningen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marywinnie","family":"Nanyaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisbet","family":"Sviland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Ngadaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Muller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisete","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayoki","family":"Mfinanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tehmina","family":"Mustafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"97010_CR1","unstructured":"WHO. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB\/RIF assay for the diagnosis of pulmonary and extra- pulmonary TB in adults and children. Policy update., (WHO, Geneva, WHO, 2013, 2013)."},{"key":"97010_CR2","doi-asserted-by":"publisher","first-page":"CD012768","DOI":"10.1002\/14651858.CD012768.pub2","volume":"8","author":"M Kohli","year":"2018","unstructured":"Kohli, M. et al. Xpert((R)) MTB\/RIF assay for extrapulmonary tuberculosis and rifampicin resistance. Cochrane Database Syst. Rev. 8, CD012768. https:\/\/doi.org\/10.1002\/14651858.CD012768.pub2 (2018).","journal-title":"Cochrane Database Syst. Rev."},{"key":"97010_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7860\/JCDR\/2015\/12422.5792","volume":"9","author":"M Purohit","year":"2015","unstructured":"Purohit, M. & Mustafa, T. 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